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The effect of food withdrawal in children with rapid-transit constipation.

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Dr Swati Bhave    10 April 2018

Rapid proximal colonic transit with anorectal holdup is a subtype of chronic constipation linked to food intolerance.

A study published in Pediatric Surgery International aimed to determine the effectiveness of dietary exclusion as a treatment modality for constipated children with rapid-transit constipation.

This study recruited 125 children with chronic constipation and rapid proximal colonic transit from an institute, between 1998 and 2014, who instructed and encouraged to undertake a six-food elimination diet, targeting common protein allergens (dairy, wheat, soy, eggs, nuts, seafood). These patients participated in a questionnaire on diet and symptoms.

The findings showed that among the 44 responders 26, with a mean age of 11 years, had attempted elimination diet whereas 18 had not. Dairy and wheat were the most common foods eliminated; meanwhile, symptomatic improvement was greater for patients who had completely eliminated foods. In addition, constipation, abdominal pain and pain on defecation were reduced. However, it was reported that their families encountered problems with dietary exclusion, especially with respect to expense. Furthermore, assistance from a dietician or nutritionist was sought by >50 % of the families.

From the findings, it was inferred that dietary exclusion is a promising strategy to treat constipation in children with rapid proximal colonic transit. However, this strategy is difficult to follow for many families, thus, the identification of the cause should be carried out more specifically and a better set of instructions should be provided for the family and/or dietitians.

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